Types of suicide process among psychoactive substance users

Suicidologijoje stokojama duomenų apie psichoaktyvių medžiagų vartojimo vaidmenį savižudybės procese bei impulsyvių ir neimpulsyvių mėginimų nusižudyti skirtumus. Šiame tyrime atlikta 15 vartojančių alkoholį arba narkotikus asmenų, per paskutinius metus mėginusiųjų nusižudyti, kokybinių interviu teminė analizė. Tyrimas leido išskirti ne du, kaip aprašoma literatūroje, o tris mėginimų nusižudyti tipus, būdingus vartojantiems psichoaktyvias medžiagas: planuoti, neplanuoti ir mėginimai nusižudyti „aptemus sąmonei“, ir aprašyti visiems jiems būdingus bruožus. Nepaisant kai kurių ribotumų, šis tyrimas gali pasiūlyti vertingų įžvalgų vertinant vartojančių psichoaktyvias medžiagas asmenų suicidinę rizikąResearch regarding the role of psychoactive substance use in the process of suicide is lacking in current suicidology. In addition to this, evidence shows that impulsive suicide attempts are common among substance users. However there is no clear understanding of the impulsive suicide process. That makes it difficult to combine results of different studies and create clear guidelines for impulsive suicide risk evaluation. The purpose of this research is to depict the impulsive and non-impulsive process of suicide among psychoactive substance users. The participants of the study were 15 psychoactive substance (10 – alcohol, 5 – drug) users, who had attempted suicide during the last year. 8 of them attempted once, 4 – two or three times, other 3 – more than 5 times. All participants – 4 women and 11 men were patients from Vilnius Centre for Addictive Disorders and Vilnius Mental Health Centre. Qualitative interviews based on Suicide Intent Scale were conducted about the suicide attempt or attempts. A thematic analysis of the interviews was used to depict the process of suicide. This study led to distinguishing 3 different types of attempted suicide – planned, unplanned and suicide attempts during a “blackout” – which are typical for psychoactive substance users. Both unplanned suicide attempts and suicide attempts during a “blackout” can be called impulsive, though the latter diverged by their hastiness, aggressiveness, inability to control one’s behaviour, intensive feeling of anger, serious danger caused to health and wellbeing, as well as a following amnesia of a major part of the suicide attempt. Intensive emotions, especially anger and stressors in interpersonal relationships, had a major impact for the respondents in the process of suicide. According to the participants of the survey, substance use had intensified their suicidal crisis having a clear effect on their emotional, relationship and other difficulties. In addition, alcohol and drug use was considered as one of the suicide methods. Despite several restrictions of the research, the study results provide some valuable insight in the suicide risk evaluation among psychoactive substance user